Federal government involvement crucial for solution, says Oswald

Lisa Tssessaze suffered third-degree burns and lung damage in a 2006 fire. She died last month after a tracheal tube inserted to help her breathe was removed.

A provincial review into the latest death on a remote reserve won't fix health-care services for aboriginal Canadians, Health Minister Theresa Oswald said Wednesday.

A day after the province announced a review into the death of a woman last month whose parents say was denied a medevac flight for medical care, Oswald confirmed the province believes what's needed is a major overhaul of health care on First Nations.

Red tape creates complicated system

Overlapping government jurisdictions add red tape and political push-back to medical services on First Nations creating complications that don't exist for other Canadians.

Under treaty obligations, the federal government is responsible for providing health care, but geography, funding and even the kinds of services Ottawa can handle limit programs, especially in remote areas.

And Canada's constitution makes health care a provincial responsibility, so each province comes up with its own plan.

In Manitoba, the province pays doctors' bills, including the cost of regular flights to make the rounds of 30 northern communities, while Ottawa pays nurses to staff nursing stations and is responsible for medevac costs and flights for appointments to see doctors.

Lisa Tssessaze, for instance, flew to Thompson monthly for eight years to have her tracheal tube checked. The tube was inserted after she suffered extensive burns and lung damage in a 2006 house fire that killed one of her children and left a second in a wheelchair. Her family blames the removal of the tube, and a lack of followup care, for the severe breathing problems that killed her.

"We have a system in place to do whatever we can to assist the federal government and we want that system to work. It's critical for everybody," Oswald said.

Discussions on reform date back two years with the Assembly of Manitoba Chiefs, the province-wide political organization for First Nations, the provincial health minister said, but progress is stalled until federal officials join the talks.

The federal government issued a statement through a spokesman Wednesday to say Ottawa has teamed up with the province in its review of Lisa Tssessaze's death on May 27.

Tssessaze, 30, was a disabled mother of two who collapsed on the floor of the Lac Brochet nursing station and died despite desperate phone calls from nurses to airlift her to see a doctor in Thompson, the family and northern chiefs told a press conference this week.

Chiefs have called for an inquest into the death and the state of northern health care. The death on the remote Dene First Nation, 1,015 kilometres northwest of Winnipeg, is the latest case northern reserve leaders blame on health-care gaps and jurisdictional fights over which level of government is responsible for the services.

Manitoba Keewatinowi Okimakanak, which represents 30 northern First Nations, lodged a formal complaint about Tssessaze's treatment with the College of Physicians and Surgeons of Manitoba, an MKO spokesman confirmed Wednesday.

The MKO and the family claim Tssessaze died as a result of negligence on the part of at least two doctors: one in Winnipeg who removed a tracheal tube that had been in place for eight years and another in Thompson who denied nurses' pleas for a medevac flight.

Oswald said she must await the results of the province's review before commenting on the specifics of the latest death, but there are basic conclusions she can make in the meantime about health care on First Nations.

"This case, the very clear and tragic pain of this family, in addition to all the data about the disparity of health status between aboriginal and non-aboriginal Canadians, that all Canadians must know by now, tells us we need to do more," Oswald said.

Talks to reshape First Nations health care are at a preliminary stage even after two years of work, Oswald said. She said she wrote her federal counterpart in 2011 to open discussions with Ottawa and Manitoba First Nations.

A year later, the Assembly of Manitoba Chiefs followed up with another invitation and submitted a proposal to guide the process for reform.

The federal government has concluded health reforms in British Columbia. Under that agreement, Ottawa channels its share of funding directly to First Nations so they can contract for the services they need, creating health authorities for aboriginal communities.

Oswald said it's too early to say if the B.C. model could be adapted to Manitoba, but the first step is to secure a federal commitment to talk about improving health services on reserves.

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